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Ventilatory Support

Ventilatory Support − Mechanical Ventilation

Mechanical ventilation or ventilatory support means the patient is on a machine that helps them breathe. A tube is put in through their nose or mouth into the trachea (windpipe). It is attached to a ventilator.

The ventilator is a machine that can give a breath to a patient who may have trouble breathing or is not able to breathe. The number of breaths and the amount of volume or pressure given at each breath are set by the Cardiac Intensive Care Unit (CICU) team.

Reasons for Mechanical Ventilation

Often patients need to be on a breathing machine either before, during or after a heart operation or a procedure, such as a cardiac catheterization.

Patients need mechanical ventilation at these times because they are given anesthesia or sedation that can suppress their own drive to breathe. Often it is needed to control breathing so the heart can rest. Sometimes, patients will be able to come off the ventilator before leaving the operating room. After surgery, most babies arrive in the CICU on the ventilator. How long a patient stays on the ventilator depends on how severe the cardiac defect is and the type of surgery done.

Description of Mechanical Ventilation

Does it hurt?

Patients receive sedation while they are on the ventilator. This helps with their comfort and helps them stay somewhat still in bed.

Sometimes patients will need arm or leg restraints. This prevents them from pulling out any tubes or intravenous catheters. This also prevents damage to their airway while the breathing tube is in place.

This is needed because they may not be able to breathe on their own yet if they pull the breathing tube out.

Extubation

If the patient is doing well after surgery, the care team may decide to extubate (pull the breathing tube out).

When it is time to take the patient off the breathing machine, settings on the ventilator are turned down. This allows them to breathe more on their own.

When they are awake enough, the breathing tube is removed and the ventilator is turned off.

After the patient is off of the breathing machine, they may need to wear oxygen for a little while. The oxygen is given through a nasal cannula (two-pronged plastic tubing) that fits into the nose.

In some cases, other treatments such as chest physiotherapy (CPT) or breathing treatments are needed.

Who operates the controls on the ventilators or performs other respiratory treatments?

Respiratory therapists are professional, trained staff who work with all aspects of respiratory care. Cincinnati Children's CICU has 13. They staff the unit 24 hours a day, seven days a week.

Respiratory therapists work with many types of patients with varied needs.

If you need to contact someone in respiratory care for the CICU, call Angela Saunders at 513-305-8776.

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Last Updated 09/2018

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